Inpatient admissions and mortality of anorexia nervosa patients according to their preceding psychiatric and somatic diagnoses

IF 5.3 2区医学 Q1 PSYCHIATRY Acta Psychiatrica Scandinavica Pub Date : 2024-02-26 DOI:10.1111/acps.13676

Natalie C. Momen, Jindong Ding Petersen, Zeynep Yilmaz, Birgitte D. Semark, Liselotte Vogdrup Petersen

{"title":"Inpatient admissions and mortality of anorexia nervosa patients according to their preceding psychiatric and somatic diagnoses","authors":"Natalie C. Momen, Jindong Ding Petersen, Zeynep Yilmaz, Birgitte D. Semark, Liselotte Vogdrup Petersen","doi":"10.1111/acps.13676","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>Anorexia nervosa (AN) is associated with increased risk of mortality, but little is known about the risk of inpatient admissions and mortality outcomes in individuals with diagnoses of both AN and other psychiatric and somatic conditions. We aimed to investigate the inpatient admissions and mortality among people with AN and other diagnosed conditions using Danish national registers.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>This retrospective cohort study included individuals diagnosed with AN in Denmark, born 1977–2010. We identified other mental and somatic conditions in this population. We used Cox proportional hazards regression to estimate the risk of inpatient admission and mortality, focusing on (i) the number of other diagnosed conditions, and (ii) specific combinations of conditions diagnosed prior to the AN diagnosis. Categories of inpatient admissions considered were due to: (i) AN, (ii) any psychiatric disorder, and (iii) any somatic disorder. Additionally, competing risks survival analysis was used to calculate the cumulative incidence of inpatient admission and all-cause mortality over the follow-up period.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The study population included 11,489 individuals. The most common conditions individuals had prior to their AN diagnosis were other eating disorders (34.5%) and anxiety disorders (32.7%). During the follow-up, 3184 (27.7%), 4604 (40.1%), and 6636 (57.8%) individuals were admitted for AN, any psychiatric disorder, and any somatic disorder, respectively; and in total 106 (0.9%) died. The risk of all outcomes was highest among those who had received a higher number of other diagnoses. For most combinations, the risks of admission and mortality were increased.</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>Our study presents the prevalence of other conditions in patients with AN in Denmark and elucidates their association with higher rates of inpatient admission and mortality. Our findings highlight the need for comprehensive, multidisciplinary care of patients with AN considering the spectrum of other diagnosed conditions to improve health outcomes.</p>\n </section>\n </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":null,"pages":null},"PeriodicalIF":5.3000,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13676","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Psychiatrica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/acps.13676","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Anorexia nervosa (AN) is associated with increased risk of mortality, but little is known about the risk of inpatient admissions and mortality outcomes in individuals with diagnoses of both AN and other psychiatric and somatic conditions. We aimed to investigate the inpatient admissions and mortality among people with AN and other diagnosed conditions using Danish national registers.

Method

This retrospective cohort study included individuals diagnosed with AN in Denmark, born 1977–2010. We identified other mental and somatic conditions in this population. We used Cox proportional hazards regression to estimate the risk of inpatient admission and mortality, focusing on (i) the number of other diagnosed conditions, and (ii) specific combinations of conditions diagnosed prior to the AN diagnosis. Categories of inpatient admissions considered were due to: (i) AN, (ii) any psychiatric disorder, and (iii) any somatic disorder. Additionally, competing risks survival analysis was used to calculate the cumulative incidence of inpatient admission and all-cause mortality over the follow-up period.

Results

The study population included 11,489 individuals. The most common conditions individuals had prior to their AN diagnosis were other eating disorders (34.5%) and anxiety disorders (32.7%). During the follow-up, 3184 (27.7%), 4604 (40.1%), and 6636 (57.8%) individuals were admitted for AN, any psychiatric disorder, and any somatic disorder, respectively; and in total 106 (0.9%) died. The risk of all outcomes was highest among those who had received a higher number of other diagnoses. For most combinations, the risks of admission and mortality were increased.

Discussion

Our study presents the prevalence of other conditions in patients with AN in Denmark and elucidates their association with higher rates of inpatient admission and mortality. Our findings highlight the need for comprehensive, multidisciplinary care of patients with AN considering the spectrum of other diagnosed conditions to improve health outcomes.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

根据厌食症患者之前的精神和躯体诊断确定其入院情况和死亡率。

目的：神经性厌食症（AN）与死亡风险增加有关，但人们对同时诊断为神经性厌食症和其他精神及躯体疾病的患者的住院风险和死亡结果知之甚少。我们的目的是利用丹麦全国登记册调查AN和其他诊断病症患者的住院率和死亡率：这项回顾性队列研究纳入了丹麦1977-2010年出生的被诊断患有自闭症的患者。我们还确定了这一人群中的其他精神和躯体疾病。我们使用 Cox 比例危险度回归法估算了入院风险和死亡率，重点关注(i) 其他诊断病症的数量，以及(ii) AN 诊断前诊断病症的特定组合。考虑的住院病人类别包括(i) AN，(ii) 任何精神疾病，以及 (iii) 任何躯体疾病。此外，该研究还采用了竞争风险生存分析法来计算随访期间的住院累积发生率和全因死亡率：研究对象包括 11,489 人。在确诊AN之前，患者最常见的疾病是其他进食障碍（34.5%）和焦虑症（32.7%）。在随访期间，分别有3184人（27.7%）、4604人（40.1%）和6636人（57.8%）因AN、任何精神疾病和任何躯体疾病入院；共有106人（0.9%）死亡。在接受其他诊断次数较多的人群中，出现所有结果的风险最高。在大多数组合中，入院和死亡的风险都有所增加：我们的研究介绍了丹麦AN患者中其他疾病的发病率，并阐明了这些疾病与较高的住院率和死亡率之间的关系。我们的研究结果凸显了对AN患者进行全面、多学科护理的必要性，并考虑到了其他已确诊疾病的范围，以改善健康状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.